In this section:

• Ovarian ultrasound scanning
• CA125 blood test
• Prophylactic salpingoo-oopherectomy
• Outpatient clinics

Related links:

• Awareness of the signs and symptoms of cancer
• Ovacome web site (external site)  - ovarian cancer support network

Depending on the family history and referral guidelines, ovarian cancer surveillance may be recommended. Individuals are encouraged to contact the GP if they experience any of the signs and symptoms of ovarian cancer. WMFACS surveillance guidelines can be found in the guidelines section.

Ovarian ultrasound scanning

Currently there is no evidence that surveillance for individuals at near-population risk or outside the referral guidelines has an effect on mortality or morbidity. Many centres may only undertake ovarian surveillance of individuals who have a family history of cancer as part of a nationwide surveillance trial (UK National Familial Ovarian Cancer Screening Study - UKFOCSS)

Ultrasound scanning can be used to ascertain the size and texture of the ovaries. Preparation for the scan includes drinking a pint of fluid (not water or carbonated drinks) an hour prior to the scan. Gel is applied and a small probe is placed over the abdomen to examine the uterus and ovaries. A transvaginal scan will also be performed. The bladder is emptied prior to the transvaginal scan, a small probe is inserted in to the vagina and moved to obtain the best images. Some patients may find the scan slightly uncomfortable. The test can be undertaken during menstruation.

Ovarian surveillance is limited in that "false positives" can occur, causing a great deal of anxiety for women. Unnecessary surgery may be required to exclude the possibility of ovarian cancer in some cases. "False negative" results also occur and a small number of women will be falsely reassured.

CA125 blood test

The patient may also have an annual blood test to assess CA125 levels. This may be done at the GP's surgery or at a hospital outpatient appointment. CA 125 is a protein (tumour marker) that may be released into the blood in higher levels in women who may have ovarian cancer. However, it is possible to have normal CA 125 levels and have ovarian cancer, or have raised levels of CA125 and not have ovarian cancer. This is because not all ovarian cancers produce this tumour marker and factors such as menstruation, pregnancy and benign tumours may also affect CA125 levels.

Prophylactic salpingo-oophorectomy

Women with a strong family history and who are at high risk of ovarian and/or breast cancer, may wish to discuss prophylactic salpingo-oophorectomy with a gynaecologist. They may wish to undergo surgery because of limitations of ovarian surveillance, if they are at an age where they may naturally enter the menopause, or if they have coexisting gynaecological problems requiring surgical intervention.

For women who undergo prophylactic salpingo-oophorectomy prior to a natural age of the menopause, HRT is not contraindicated, even if there is a strong family history of breast cancer.

Oophorectomy has also been shown to reduce the incidence of breast cancer in some women; studies indicate a reduction in incidence of between a third and a half in pre-menopausal women.

Outpatient clinics

Depending on individual circumstances, the patient may be offered a regular appointment with the gynaecologist or specialist nurse.

Depending on individual circumstances breast surveillance may also be recommended for individuals who have family histories of ovarian cancer.